Infectious Typhoid

Question 1

Fever
Abdominal pain
Enlarged peyer’s and mesenteric LN

Answer 1

Typhoid Enteric fever

Question 2

Typhoid organism

Answer 2

S typhi

S paratyphi

Question 3

Human host
Food/water borne
Fecal contamination by ill or asymptomatic chronic carrier
Sexual
Health care exposure

Answer 3

Typhoid

Question 4

Clone H58 is resistant to

Answer 4

Quinolone

Question 5

Not a known risk factor for enteric fever

Answer 5

Recent travel to SEA

Question 6

Typhoid rf:

Answer 6

Contaminated food
Flooding
Sewage fertilized crop
Ill household contact
Prior H pylori infection (chronic reduced gastric content)

Question 7

Most prominent typhoid symptom

Answer 7

Fever >75%

Abd pain 30-40-%

Question 8

Milder form presenting with GI symptom

Answer 8

Paratyphi S

Question 9

Rash of enteric fever

Answer 9

rose spot on trunk or chest

Question 10

Early physical finding 30%
Faint salmon colored blanching maculopapular rash on trunk and chest
Salmonella can be cultured from punch biopsy

Answer 10

Rose spots

Question 11

Life threatening GI complication such as bleeding and intestinal perforation occur during

Answer 11

3rd to 4th week

Question 12

Neurologic manifestation 2-40%

Answer 12

Meningitis
GBS
Neuritis
Neuropsychiatric symptoms (muttering delirium or coma vigil)

Question 13

Individuals are likely to become chronic carriers of S typhi

Answer 13

Female
Infant
Persons with biliary abnormality
Concurrent bladder infection / S. haematobium

Question 14

S typhi pxs may excrete it in feces for up to

Answer 14

3 mos

Question 15

Definitive dx of Typhoid

Answer 15

Isolation of S typhi from blood, bone marrow, sterile site, rose spot, stool

Question 16

Gives more than 80% yield not reduced up to 5 d of prior antibiotic therapy

Answer 16

Bone marrow

Question 17

Culture of intestinal secretion could br kbtajned by

Answer 17

duodenal string test

Question 18

serologic test for febrile agglutinnin

Simple rapid limited sensitivity and specificity

Answer 18

Widal test

Question 19

Typhoid tx

Answer 19

Fluoroquinolone cure rate of 98%

Relapse and fecal carriage rage <2%

Question 20

Dsc strain

Answer 20

Ciprofloxacin

Question 21

Typhoid vaccine

Answer 21

TY21a oral live attenuated

6 years

Question 22

Enteric fever

Answer 22

Salmonella typhi
Salmonella para typhi

If not 2, non-enteric

Question 23

Blood

Answer 23

1st week

Question 24

Urine culture

Answer 24

2nd week

Question 25

Stool culture

Answer 25

3rd week of illness

Question 26

Brunner’s gland

Answer 26

Duodenum

Question 27

Peyer’s

Answer 27

Ileum

Question 28

Picking at bed clothes | Imaginary objects

Answer 28

coma vigil

Question 29

Low utterences Slurring of speech Restlesness

Answer 29

Muttering delirium

Question 30

Reservoir of salmonella

Answer 30

Gallbladder

Question 31

Most prominent symptom

Answer 31

Fever

Question 32

Roth spot

Answer 32

Infective endocarditis

Question 33

Board like abdomen

Answer 33

Perforated typhoid ileitis

Question 34

Most common site of perforation in bowel

Answer 34

Cecum

Question 35

Cecum rupture is likely bec of

Answer 35

Law of laplace The higher the diameter, the higher pressure

Question 36

Single most sensitive method of diagnosis of Typhoid fever

Answer 36

Blood or bone marrow c

Question 37

Empiric tx for typhoid

Answer 37

Ceftriaxone

Question 38

Cephalosporins for empiric tx of enteric fever

Answer 38

Cefotaxime 2gm q8 IV Cefixime 400mg BID PO Ceftriaxone 2gm/day IV

Question 39

Optimal tx for fully susceptible enteric fever in adult

Answer 39

Ciprofloxacin